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Diagnosis and staging of carpal tunnel syndrome: Comparison of magnetic resonance imaging and intra-operative findings

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Summary

Purpose: In order to determine the reliability of magnetic resonance imaging (MRI) in the diagnosis and staging of carpal tunnel syndrome (CTS), the most common entrapment neuropathy, the following prospective study has been performed.Methods: We compared clinical and electrophysiological studies in 58 cases of CTS with MRI investigations and confirmed the reliability by exact correspondence with intra-operative findings.Results: Typical MRI characteristics of the median nerve in CTS have been established. There is a significant difference in flattening (p < 0.05), swelling (p < 0.01) and signal intensity (p < 0.05) of the median nerve between early and advanced CTS. Comparison of MRI and intra-operative findings revealed that median nerve compression was diagnosed correctly in 91% of cases. Additional lesions in the carpal tunnel, which are a primary cause of nerve compression, were established by MRI in 25 cases and confirmed by surgery.Conclusion: MRI is a reliable diagnostic tool for assessing as well as staging of CTS. Morphological changes following chronic nerve compression can be visualized. It is particularly useful in cases of suspected lesions within the carpal tunnel as a cause of CTS. The information provided may support the choice of adequate treatment modality.

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References

  1. Binkovitz LA, Cahill DR, Ehman RL, Berquist TH (1988) Magnetic resonance imaging of the wrist: normal cross-sectional imaging and selected abnormal cases. RadioGraphics 8: 1171–1202

    PubMed  Google Scholar 

  2. Bleecker ML, Bohlman M, Moreland R, Tipton A (1985) Carpal tunnel syndrome: role of carpal canal size. Neurology 35: 1599–1604

    PubMed  Google Scholar 

  3. Fahr LM, Sauser DD (1988) Imaging of peripheral nerve lesions. Orthop Clin North Am 19: 2741

    Google Scholar 

  4. Fodor J, Malott JC, Merhar GL (1987) Carpal tunnel syndrome: the role of radiography. Radiol Technol 58: 497–501

    PubMed  Google Scholar 

  5. Gelberman RH, Rydevik BL, Pess GM, Szabo RM, Lundborg G (1988) Carpal tunnel syndrome. A scientific basis for clinical care. Orthop Clin North Am 19: 115–124

    PubMed  Google Scholar 

  6. Heuck A, Steinbach L, Neumann C, Stoller D, Genet H (1989) Möglichkeiten der MR-Tomographie bei Erkrankungen von Hand und Handgelenk. Radiologe 29: 53–60

    PubMed  Google Scholar 

  7. Hinshaw WS, Andrew ER, Bottomley PA, Holland GN, Moore WS, Worthington BS (1979) An in vivo study of the fore-arm and hand by thin section NMR imaging. Br J Radiol 52: 36–43

    PubMed  Google Scholar 

  8. Jessurun W, Hillen B, Zonnefeld F, Huffstadt AJC, Beks JWF, Overbeer W (1987) Anatomical relations in the carpal tunnel: a computed tomographic study. J Hand Surg 12B: 64–67

    Google Scholar 

  9. Koenig H, Lucas D, Meissner R (1986) The wrist: a preliminary report on high-resolution MR-imaging. Radiology 160: 463–467

    PubMed  Google Scholar 

  10. Lanz T, Wachsmuth W (1959) Praktische Anatomie: Arm, Vol 2. Springer, Berlin Göttingen Heidelberg

    Google Scholar 

  11. Marie F, Foix C (1913) Atrophie isolé de l'eminence thenar d'origin nevritique. Role du ligament annulaire anterieur du carpe dans la pathogenie de la lesion. Rev Neurol 26: 647–649

    Google Scholar 

  12. Merhar GL, Clark RA, Schneider HJ, Stern PJ (1986) Highresolution computed tomography of the wrist in patients with carpal tunnel syndrome. Skeletal Radiol 15: 549–552

    PubMed  Google Scholar 

  13. Mesgarzadeh M, Schneck CD, Bonakdarpour A (1989) Carpal tunnel: MR imaging. Part I. Normal anatomy. Radiology 171: 743–748

    PubMed  Google Scholar 

  14. Mesgarzadeh M, Schneck CD, Bonakdarpour A, Mitra A, Conaway D (1989) Carpal tunnel: MR imaging, Part II. Carpal tunnel syndrome. Radiology 171: 749–754

    PubMed  Google Scholar 

  15. Middleton WD, Kneeland JB, Kellman GM, Cates JD, Sanger JR, Jesmanowicz A, Froncisz W, Hyde JS (1987) MR imaging of the carpal tunnel: normal anatomy and preliminary findings in the carpal tunnel syndrome. AJR 148: 307–316

    PubMed  Google Scholar 

  16. Murphy RX, Chernofsky MA, Osborne MA, Wolson AH (1993) Magnetic resonance imaging in the evaluation of persistent carpal tunnel syndrome. J Hand Surg 18A: 113–120

    Google Scholar 

  17. Phalen GS: The carpal tunnel syndrome (1972) Clinical evaluation of 598 hands. Clin Orthop Relat Res 83: 29–40

    PubMed  Google Scholar 

  18. Richman JA, Gelberman RH, Rydevik BL, Gylys-Morin VM, Hajek PC, Sartoris DJ (1987) Carpal tunnel volume determination by magnetic resonance imaging three-dimensional reconstruction. J Hand Surg 12A: 712–717

    Google Scholar 

  19. Richman JA, Gelberman RH, Rydevik BLet al (1989) Carpal tunnel syndrome: morphologic changes after release of the transverse carpal ligament. J Hand Surg 14A (5): 852–857

    Google Scholar 

  20. Schmitt R, Lucas D, Buhmann S, Lanz U, Schindler G (1988) Computertomographische Befunde beim Karpaltunnelsyndrom. RöFo 149: 280–285

    Google Scholar 

  21. Schmidt HM, Moser T, Lucas D (1987) Klinisch-anatomische Untersuchungen des Karpaltunnels der menschlichen Hand. Handchir Mikrochir Plastchir 19: 145–152

    Google Scholar 

  22. Sunderland S (1976) The nerve lesion in the carpal tunnel syndrome. J Neurol Neurosurg Psychiatry 39: 615–626

    PubMed  Google Scholar 

  23. Tanzer RC (1959) The carpal tunnel syndrome: a clinical and anatomic study. J Bone Joint Surg 41A: 626–634

    Google Scholar 

  24. Weiss KL, Beltran J, Shaman OM, Stilla RF, Levey M (1986) High-field MR surface-coil imaging of the hand and wrist. Part I. Normal anatomy. Radiology 160: 143–146

    PubMed  Google Scholar 

  25. Weiss KL, Beltran J, Shaman OM, Stilla RF, Levey M (1986) High-field MR surface coil imaging of the hand and wrist. Part II. Pathologic correlations and clinical relevance. Radiology 160: 147–152

    PubMed  Google Scholar 

  26. Weißenborn W, Sabri W (1987) Muskelanomalien als Ursache des Karpaltunnelsyndroms. Handchir Mikrochir Plastchir 19: 153–155

    Google Scholar 

  27. Zucker-Pinchoff B, Herman G, Srinivasan R (1981) Computed tomography of the carpal tunnel: a radioanatomical study. J Comput Assis Tomogr 5: 525–528

    Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, University of Cologne, Federal Republic of Germany

    A. Kleindienst, G. Hildebrandt & N. Klug

  2. Department of Radiology, Charité, Humboldt-Universität zu Berlin, Federal Republic of Germany

    B. Hamm

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  1. A. Kleindienst
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  2. B. Hamm
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  3. G. Hildebrandt
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  4. N. Klug
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Kleindienst, A., Hamm, B., Hildebrandt, G. et al. Diagnosis and staging of carpal tunnel syndrome: Comparison of magnetic resonance imaging and intra-operative findings. Acta neurochir 138, 228–233 (1996). https://doi.org/10.1007/BF01411366

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